Correlation between in vitro resistance to fluconazole and clinical outcome of oropharyngeal candidiasis in HIV-infected patients

Quereda, Carmen; Polanco, Ana M.; Giner, Consuelo Pedrón; Sánchez‐Sousa, A.; Pereira, Érika Sales Joviano; Navas, Enrique; Fortün, Jesús; Guerrero, Antonio; Baquero, Fernando

doi:10.1007/bf01586182

Cited by 46 publications

(18 citation statements)

References 38 publications

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“…Using a non-M27 broth-based method, Cartledge et al reported that infections due to isolates with fluconazole MICs of Ͼ8 g/ml were unlikely to respond to 100 mg of fluconazole per day (27). Quereda reported that infections due to isolates with fluconazole MICs of Ն8 g/mL (by M27-A, but in medium supplemented to 20 g of glucose per liter) were less likely to respond to 100 mg of fluconazole per day (173). Using doses of fluconazole that increased from 100 mg/day to as high as 800 mg/day as needed, Revankar et al reported that clinical failure only occurred when the M27-A MIC was Ն64 g/ml (178).…”

Section: Support For the Clinical Relevance Of Nccls M27 Mics In Yeastsmentioning

confidence: 99%

Antifungal Susceptibility Testing: Practical Aspects and Current Challenges

Rex¹,

et al. 2001

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Development of standardized antifungal susceptibility testing methods has been the focus of intensive research for the last 15 years. Reference methods for yeasts (NCCLS M27-A) and molds (M38-P) are now available. The development of these methods provides researchers not only with standardized methods for testing but also with an understanding of the variables that affect interlaboratory reproducibility. With this knowledge, we have now moved into the phase of (i) demonstrating the clinical value (or lack thereof) of standardized methods, (ii) developing modifications to these reference methods that address specific problems, and (iii) developing reliable commercial test kits. Clinically relevant testing is now available for selected fungi and drugs: Candida spp. against fluconazole, itraconazole, flucytosine, and (perhaps) amphotericin B; Cryptococcus neoformans against (perhaps) fluconazole and amphotericin B; and Aspergillus spp. against (perhaps) itraconazole. Expanding the range of useful testing procedures is the current focus of research in this area

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Section: Support For the Clinical Relevance Of Nccls M27 Mics In Yeastsmentioning

confidence: 99%

Antifungal Susceptibility Testing: Practical Aspects and Current Challenges

Rex¹,

et al. 2001

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“…However, when caspofungin was used for the treatment of patients with candidemia, those with C. parapsilosis fungemia (14 of 20) responded as well as those with C. albicans and other species (13 of 20) (8). Therefore, the correlation of in vitro susceptibility and clinical response, at least for C. parapsilosis, does not seem as close for caspofungin as for fluconazole (4,6,12). Additionally, pharmacokinetic considerations such as drug access to sites of infection, distribution in tissue, or clearance may contribute to clinical failure.…”

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confidence: 99%

Caspofungin Resistance inCandida albicans: Correlating Clinical Outcome with Laboratory Susceptibility Testing of Three Isogenic Isolates Serially Obtained from a Patient with Progressive Candida Esophagitis

Hernandez

López-Ribot

Najvar

et al. 2004

Antimicrob Agents Chemother

157

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A patient with azole-refractory thrush-esophagitis responded initially to caspofungin, but the treatment eventually failed. In a murine model, caspofungin was effective against two early isolates for which the MICs of caspofungin were low, but it was less effective against a late isolate for which the MIC of caspofungin was greater. We concluded that there is a correlation between in vivo failure and rising in vitro caspofungin MICs.

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“…In recent years azole agents have become the drugs of choice for treating both oropharyngeal candidiasis and VVC (16,18). However, recent studies have indicated the possibility of treatment failures associated with C. albicans resistance to azoles (4,12).…”

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confidence: 99%

Antifungal Activities of Two New Azasordarins, GW471552 and GW471558, in Experimental Models of Oral and Vulvovaginal Candidiasis in Immunosuppressed Rats

Martı́nez

Ferrer

Santos

et al. 2001

Antimicrob Agents Chemother

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Sordarins constitute a new class of antifungal agents with a novel mechanism of action involving the selective inhibition of fungal protein synthesis. A further evolution of this class of antifungals has led to a new family of sordarin derivatives called azasordarins. The therapeutic efficacies of two new azasordarins, GW471552 and GW471558, were studied in experimental models of oral and vulvovaginal candidiasis in immunosuppressed rats. In all cases rats were immunosuppressed with dexamethasone in the drinking water. Oral candidiasis was established by inoculating 0.1 ml of a yeast suspension containing 5 ؋ 10 8 cells of Candida albicans 4711E with a cotton swab on three alternate days. Vulvovaginal candidiasis was established in ovariectomized and estrus-induced rats by intravaginal inoculation of 10 7 CFU of C. albicans 4711E in 0.1 ml of saline. GW471552 and GW471558 were administered at 1, 5, and 10 mg/kg of body weight via the subcutaneous route. In oral candidiasis, azasordarins were administered each 8 h for 7 consecutive days, while in vaginal candidiasis the compounds were given each 4 h for 3 consecutive days. Antifungal activity of azasordarins was assessed by colony counts and by histological examination 1 day after treatment. In the oral infection model, GW471552 and GW471558 administered at 5 mg/kg significantly reduced (P < 0.05) the number of CFU of C. albicans compared with untreated controls. In addition, GW471552 and GW471558 given at 10 mg/kg eradicated C. albicans from the oral cavities of 100% of infected animals. Against vulvovaginal infection, both compounds showed significant therapeutic efficacy. GW471552 was able to eradicate the vaginal fungal burden at a dose of 10 mg/kg, and it significantly reduced the number of CFU of C. albicans in vaginas of rats treated with a dose of 5 mg/kg (P < 0.05). GW471558 showed greater efficacy, eradicating the fungal burden of 100% of infected rats at a dose of 5 mg/kg and significantly reducing (P < 0.05) the C. albicans vaginal counts even at a dose of 1 mg/kg. In both therapeutic efficacy studies, the histological findings confirmed the microbiological results. The experimental results presented show that the tested azasordarins are effective against oral and vulvovaginal candidiasis in immunosuppressed rats and could be promising antifungal agents for use in humans.

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Correlation between in vitro resistance to fluconazole and clinical outcome of oropharyngeal candidiasis in HIV-infected patients

Cited by 46 publications

References 38 publications

Antifungal Susceptibility Testing: Practical Aspects and Current Challenges

Antifungal Susceptibility Testing: Practical Aspects and Current Challenges

Caspofungin Resistance inCandida albicans: Correlating Clinical Outcome with Laboratory Susceptibility Testing of Three Isogenic Isolates Serially Obtained from a Patient with Progressive Candida Esophagitis

Antifungal Activities of Two New Azasordarins, GW471552 and GW471558, in Experimental Models of Oral and Vulvovaginal Candidiasis in Immunosuppressed Rats

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